Memorandum by Infectious Disease Research
1. The Infectious Disease Research Network
(IDRN) fully supports the priority now being given to infectious
diseases with the strategy document Getting Ahead of the Curve.
2. Getting Ahead of the Curve emphasizes
the importance of research and development in combating infectious
diseases and outlines a proposal for a research and innovation
3. While much excellent research is ongoing
in universities and at the Public Health Laboratory Service, this
research is fragmented and, as identified in Getting ahead
of the Curve, there is no strategy for infectious diseases
research currently. Co-ordinated effort is needed to develop such
4. There is also a need to encourage collaborative,
multidisciplinary working in order to develop research that will
inform policies to tackle the complex issues involved.
5. Whether considering the surveillance,
diagnosis, treatment or prevention of infectious disease, quality
research requires three basic elements: co-ordinated research
strategy, high-quality design methodology and professionally managed
6. The IDRN was conceived in 2001 (and funded
by the London Regional Office of the Department of Health) with
the aims of stimulating the development of research strategy in
priority infectious diseases and to facilitate the implementation
of high quality, inter-disciplinary, pan-London (or broader) collaborative
research. Currently operating mainly in London, the IDRN is planning
to operate on a national basis within five years.
7. The IDRN is directed by a Steering Group
having representation from all the London Medical Schools, the
London School of Hygiene and Tropical Medicine, the Medical Research
Council Clinical Trials Unit, the Public Health Laboratory Service
and the Association of British Pharmaceutical Industries.
8. This corporate response uses data collected
during a consultation exercise with the London infectious disease
research community, which was conducted from December 2001 to
February 2002, involving the views of 126 researchers.
9. Data as to which infectious diseases
are perceived to pose the greatest threat are first provided.
A summary of the planned operations of the IDRN is then given,
in relation to how such activities will support the strategy detailed
in Getting Ahead of the Curve. The achievements of the
IDRN thus far are then briefed.
10. The consultation exercise conducted
involved assessing the threat posed by infectious diseases to
the health of Londoners, threat being defined in terms of seriousness
of disease or of burden of disease. Of twenty-one disease areas,
the greatest threats (in order, greatest threat first) were: tuberculosis,
antimicrobial resistance, HIV/AIDS, sexually transmitted infections,
health-care associated infection, hepatitis, infections as causes
of chronic disease, serious imported diseases (excluding TB and
HIV), meningococcal disease and bioterrorism agents.
IDRN ACTIVITIES THAT
Developing research strategy
11. The IDRN has initiated development of
research strategy in the fields of tuberculosis, antimicrobial
resistance and hepatitis. Work in the other priority areas is
planned to be initiated over 2003-04.
12. The IDRN plans to support collaborations
initiated during workshops with a range of activities to promote
quality research and to reduce start-up times of multicentre work.
Continuing education of professionals
Inter-disciplinary seminar series
13. Combating infectious disease requires
inter-disciplinary collaboration. Each specialization has its
own vocabulary. In order to develop research of any depth, an
appreciation of the many disciplines involvedfrom statistics,
epidemiology and mathematical modelling to microbiology, virology
and geneticsis required by members developing protocols.
To aid such understanding, the IDRN plans to develop a seminar
series with topics addressing the training needs identified during
the consultation conducted.
14. The IDRN plans to develop a searchable
database of training opportunities eg local seminar and conference
information, training courses of relevance to infectious disease
research and graduate and research training fellowship information.
Engaging researchers with policy-making and funding
Researchers' news service
15. Researchers are necessarily focused
on the work in their field. To conduct research, however, a large
body of further non-medical information is required. The IDRN
plans to develop a news service for researchers, to keep researchers
abreast of current political, ethical and legislative developments
that will have an impact on the work they do.
16. Information would also cover practical
aspects of developing research projects such as the following:
(a) A searchable database of researcher expertise
to help identify collaborators.
(b) Links to directories of reagents and
expensive equipment that can be shared for research purposes.
(c) Applying to ethics committees.
(d) Links to other research networks.
(e) Access to databases of freelance research
personnel, ie qualified research monitors and auditors.
(f) How to run clinical trials, including
a template repository of the documentation required by the EU
clinical trials directive.
Researchers' contribution to public education
Role for the media
17. The IDRN co-ordinating centre fully
supports the suggested increased capacity for providing information
to the public about infectious diseases and the risks associated
18. The IDRN co-ordinating centre also supports
an increased role for the media (TV, radio, newspapers) in raising
awareness about infectious diseases and considers that a proactive
approach from the research community should be taken.
19. Other channels of communication should
also be used to increase awareness in the high-risk groups themselves,
eg through schools, community or patient organizations or religious
leaders. Information services to patients should also be developed.
Such means could open two-way communication, which would support
20. A consultation exercise was conducted
to inform development of IDRN functions.
21. Respondents identified many advantages
to collaborative working and also informed us of current barriers,
which the IDRN, in its development, is seeking to address:
(i) Obtaining critical mass, statistical
powerthere is currently a lot of small-scale research.
Larger and more powerful studies could be conducted rather than
small rival ones. Duplication of effort could also be avoided.
(ii) Obtaining the required skill mix
for a particular projectenabling an increase in the depth
of research by bringing together those with complementary skills
but a common research focus and enabling collaborative grant applications
to be made to funding agencies.
(iii) Making the best use of limited
resourcesthe idea of pooling academic resources, facilities,
equipment, tissues, mRNA, technical resources.
(iv) Facilitating the identification
of, and communication with, collaborators.
(v) Increasing recruitment or case ascertainment
(vi) Linking research to practicecurrently,
research is not well linked to practice. Opportunities to increase
translation of research into practice exist through enabling centers
of different types (eg tertiary referral centers and District
General Hospitals and primary care groups) to work together. Researchers
could therefore work more closely with those who implement research
(vii) Improving inter-institutional communication
and breaking down obstacles (geographic, historical, logistical)
(viii) Improving the quality of research
through peer participation in study design, by drawing on the
strengths of collaborating departments.
(ix) Enabling development of longer-term
(x) Being very attractive to industry
and, thus, helping to attract major clinical trials, which are
often placed instead in the US.
(xi) Providing an effective political
(b) Barriers to collaborative working fell
into twelve major categories:
(i) Competition between institutions
rather than collaboration.
(ii) Issues of ownership.
(iii) Issues of personality and politics.
(v) Financial and funding.
(vi) Project coordination and communication.
(vii) Recognition of collaborative work.
(viii) Bureaucracy and administrative
(ix) Issues of authorship and publication.
(x) Time required for traveling around
(xi) Maintaining collaborations.
22. The IDRN has initiated activities primarily
in London with pump-prime funding from the London Regional Office
of the Department of Health.
23. To maximize critical mass gains and
efficiency in research, a national infrastructure to support infectious
diseases research needs to be developed. This network could map
onto the proposed infectious disease clinical networks, as done
by Cancer Research UK with cancer clinical networks. The IDRN
is currently developing a five-year business plan, including plans
to move to a national operational platform.
24. The IDRN is currently engaged in identifying
appropriate funding source(s) to continue development from April